Sho C. Takatori

A quasi-2-dimensional model for respiration of the cornea with soft contact lens wear.

Purpose Because neither the human cornea nor a soft contact lens (SCL) is of constant thickness, corneal oxygenation varies locally. To quantify the importance of cornea/SCL thickness variations on oxygen demand, we develop a quasi-2-dimensional (2D) respiration model that accounts for aerobic and anaerobic metabolism and bicarbonate buffering. Methods Because metabolism is critical to oxygen demand, we extend the 1-dimensional (1D), 6-layer oxygen metabolic model of Chhabra et al. Lateral diffusion is shown to be negligible. Accordingly, we adopt the 1D reactive-diffusion metabolic model but apply it locally along the cornea/lens extent. This “quasi-2D” approximation permits 2D assessment of oxygen consumption, including the effects of carbon dioxide, glucose, and lactate, bicarbonate, and hydrogen ions. We use both an oxygen deficiency factor and an excess lactate factor to gauge corneal health after accounting for both cornea and contact lens thickness variations. Results The quasi-2D respiration model provides quantitative spatial resolution of corneal oxygenation with minimal expenditure of computation time. When only aerobic oxygen loss is included, our quasi-2D approach is in excellent agreement with the fully 2D results of Alvord et al. However, the quasi-2D model predicts 2D concentration profiles of glucose, lactate ions, bicarbonate ions, hydrogen ions, and carbon dioxide, as well as oxygen. Neglect of metabolic reactions and/or thickness variations leads to inaccurate prediction of oxygen demand, especially near the lens periphery. Conclusions The quasi-2D respiration model indicates that lateral thickness variations and respiration kinetics are critical for assessing on-eye physiologic performance of an SCL. We find that oxygen deficiency factor and excess lactate factor are useful indices to gauge corneal hypoxia. A user-friendly computer program of the quasi-2D respiration model is available for lens design.

In Vivo Corneal Oxygen Uptake During Soft-Contact-Lens Wear

PURPOSE We develop a new method to compute in situ corneal oxygen uptake during soft-contact-lens (SCL) wear using a micro-polarographic Clark electrode. METHODS After steady SCL wear and subsequent removal, a membrane-covered polarographic microelectrode is immediately placed onto the cornea. The resulting polarographic signal is related to the steady-state corneal oxygen uptake rate during soft-contact-lens wear. We devise a new analysis to quantify oxygen uptake into the cornea during lens wear. The proposed procedure is applied to new polarographic data for 10 human subjects with 12 different commercial lenses during open eye. We compare our results with recent theory. RESULTS Average corneal oxygen uptake rates at open eye during SCL wear for 10 subjects wearing 12 different commercial lenses vary from 2 to 10 μL(STP)/cm(2)/h. High oxygen permeability lenses have uptake rates of -10 μL(STP)/cm(2)/h, in close agreement with our previously obtained no-lens human uptake rates of 9 to 13 μL(STP)/cm(2)/h at open eye.(40) Application of the classical data-interpretation procedure to our experimental data gives corneal-uptake results that are approximately three to five times smaller than those obtained with our new interpretation scheme. CONCLUSIONS We provide a simple and reliable tool to quantify corneal-oxygen-uptake rates during in vivo soft-contact-lens wear. Comparison of our newly measured in vivo oxygen uptakes to model prediction for SCLs of varying oxygen transmissibility is in good agreement with available theory.